LTSS Care Navigator & Care Plan Lead

Jobtome; Chicago (IL); On-site; USD 35,000 - 68,000; Full time

Benefits offered by this job

Competitive benefits

EOE employer

Job summary

Molina Healthcare is seeking a Care Coordinator to support care management and LTSS activities, collaborating with a multidisciplinary team to deliver integrated member care. The role focuses on ensuring progress toward outcomes, quality, and cost-effective services for high-need members.

Responsibilities include completing assessments, coordinating waiver enrollment, developing care plans with members and providers, monitoring progress, and facilitating team meetings.

Qualifications

• At least 2 years of health care experience including LTSS exposure.
• Clinical licensure and/or certification required only if state contract mandates it; if licensed, active/unrestricted license in state of practice.
• Bachelor's degree in a health care related field may be required depending on state/contractual requirements.
• Valid driver's license, reliable transportation for job-related travel.
• Strong communication, time-management and problem-solving skills.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians, and providers to address needs and goals.
• Monitors care plan effectiveness, documents interventions and outcomes, and suggests changes.
• Promotes integration of LTSS with behavioral health and community resources to enhance continuity of care.
• Assesses medical necessity and authorizes waiver services.
• Facilitates interdisciplinary care team meetings for approvals/denials.
• Uses motivational interviewing and Molina guidelines to educate and motivate change.
• Identifies barriers to care and supports members with psycho/social, financial, and medical challenges.
• Identifies critical incidents and develops prevention plans for member health and welfare.
• Collaborates with licensed care managers/leadership as needed.
• Travel 25-40% locally as required by state/contractual requirements.

Job description

Molina Healthcare is seeking a Care Coordinator to support care management and LTSS activities, collaborating with a multidisciplinary team to deliver integrated member care. The role focuses on ensuring progress toward outcomes, quality, and cost-effective services for high-need members.

Responsibilities include completing assessments, coordinating waiver enrollment, developing care plans with members and providers, monitoring progress, and facilitating team meetings.